Investigation of the Usability of CT in Clinical Decision Making by Comparing COVID-19 Positive and Probable Patients Diagnosed According to CT Imaging Findings

Abstract

Aim: In this study, the usability of thoracic computed tomography (CT) in clinical decision making was investigated by comparing laboratory results of patients with probable and definite coronavirus disease 2019 (COVID-19) diagnosis according to CT imaging features. Material and Methods: Within the scope of this single-center retrospective clinical study, data of possible and definite cases of COVID-19 were scanned from the hospital electronic database and patient files. Laboratory and CT imaging results of the patients were obtained. Patients were divided into two groups as positive and negative according to their CT imaging results, and compared. Results: Of the 995 patients included in the study, 57% (n=567) were male, and the mean age was 45.7±20.2 years. It was found that 65.1% (n=648) of the patients had positive CT. Real-time polymerase chain reaction (RT-PCR) test result was found positive in 22.2% (n=144) of the CT positive patients, and 32.0% (n=111) of the CT negative patients, and it was statistically significant (p<0.001). In the logistic regression analysis, it was determined that C-reactive protein (CRP), lymphocyte count, ferritin, procalcitonin, D-dimer, lactate and RT-PCR were statistically significant with CT positivity. Conclusion: In this study, COVID-19 positive and probable patients were compared according to thoracic CT findings and the usability of CT for clinical decision making was investigated. It has been determined that thorax CT can be used to initiate the treatment of COVID-19 in patients with negative RT-PCR test results but positive CT findings and high biochemical parameters such as CRP, D-dimer, ferritin and lactate.

Keywords

• COVID-19
• computed tomography
• SARS-CoV2
• pneumonia
• pandemic

BT Görüntüleme Bulgularına Göre Tanı Alan COVID-19 Pozitif ve Olası Hastaları Karşılaştırarak Klinik Karar Vermede BT'nin Kullanılabilirliğinin Araştırılması

Abstract

Amaç: Bu çalışmada bilgisayarlı tomografi (BT) görüntüleme özelliklerine göre olası ve kesin koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) tanısı alan hastaların laboratuvar sonuçları karşılaştırılarak, klinik karar verme sürecinde torasik BT’nin kullanılabilirliği araştırılmıştır. Gereç ve Yöntemler: Tek merkezli retrospektif klinik çalışma kapsamında olası ve kesin COVID-19 vakalarının verileri hastanenin elektronik veri tabanından ve hasta dosyalarından taranmıştır. Hastaların laboratuvar ve BT görüntüleme sonuçları elde edilmiştir. Hastalar BT görüntüleme sonuçlarına göre pozitif ve negatif olmak üzerek iki gruba ayrılmış ve karşılaştırılmıştır. Bulgular: Çalışmaya dahil edilen 995 hastanın %57'si (n=567) erkekti ve hastaların yaş ortalaması 45,7±20,2 yıl idi. Hastaların %65,1'inde (n=648) BT pozitifliği saptandı. Gerçek zamanlı polimeraz zincir reaksiyonu (real-time polymerase chain reaction, RT-PCR) testi sonucu BT pozitif hastaların %22,2'sinde (n=144) ve BT negatif hastaların %32'sinde (n=111) pozitif olarak bulundu ve istatistiksel olarak anlamlı idi (p<0,001). Lojistik regresyon analizinde C-reaktif protein (CRP), lenfosit sayısı, ferritin, prokalsitonin, D-dimer, laktat ve RT-PCR'nin BT pozitifliği ile istatistiksel olarak anlamlı olduğu tespit edildi. Sonuç: Bu çalışmada, torasik BT bulgularına göre COVID-19 pozitif ve olası hastalar karşılaştırılmış ve BT’nin klinik karar verme amaçlı kullanılabilirliği araştırılmıştır. RT-PCR test sonucu negatif ancak BT bulguları pozitif olan ve CRP, D-dimer, ferritin ve laktat gibi yüksek biyokimyasal parametreleri olan hastalarda, COVID-19'un tedavisine başlanmasında toraks BT'nin kullanışlı olduğu tespit edilmiştir.

Keywords

• COVID-19
• bilgisayarlı tomografi
• pnömoni
• SARS-CoV-2
• pandemi

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